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Home My WebLink AboutPermit Electrical 2011-7-1 225 Fifth Streett Springfield, OR 97477+PH(541)726-3753tFAX(541)726-3689 ".DEPARtMENT USE ONLY '.l",~;' , ..' -' ,Permit no.: Date: This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. \""''''OC''AL'''GO'V'ER N'M'E'N'T' " "ov A'L"'" , -"-,,,...+~ .' " 'L:' .' :" . , 'AI'1PR' ',!"",,;,,'F'~";i"-': Zoning approval verified" DYes D No ~;"!:HJ:;;,t;';:\CATEGORY"~O~;:cQNSTRlJC:TI1IQN~~~f;'!,, "" .:. ~' E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent OAR 479.540(1) an 479.560 I). Signature: t>-c/M~ / ~CONTRACTOR INSTALL:.ATION'. _. ~v V\..QfV" Address: City: Phone: E-mail: CCB license no.: ZIP: Fax: BCD license no.: Signing supervisor's license no.: . \0 Print name of signing supervisor: aCIW\l1; \)\,\,\'1 ll8q,- _.....(\ _ ..'tn '(\ 'l::i_';1' :\. V''- ~ Signature of sign in 'i-.~PEJ'l'l~' b \IW, ~a.!e~~0_00\- f>."€ e~ a.oo?' ,nose '~Of>." "~'JleS 0j ollo'll t\ll cell\e!. 0 \"toll~ s 01 \ne '. ~O\w ~\o\lfICa,\IO~_OO\-OO\,,' III co?,e \~e \6le~iCa,\'O(\ \' />,'" g5.. ,/ oPW 'I~o\e.. ~o\\ III 0 '<Oil (tIa.:, lI\el.. .\ II \.\\11\\'1 t\t\). oo90.. \ne ce 0~eqO _'2/3'2.-'2.'3 Ca,\lllI9 \01 Ina: \-,<>00 . ......iV ~ \(\\I([\pe\Cellwt'.,s . ~~~ ~\\" 440-2584-) (9/08/COM) ~J\~.~;fi,tlrg:~~j~t~i{;;'Af,r'it'F:EEJ~sCHE[jl!Jl:je~~}t~1il~ili'~t~M~~1i1 '. ' -,' ":.,.- ,..,.':'.-;.,"."....:";.':.: .' Cost',. 'Total . )Number'"oUnspeCtio'n's'per,item (.), .?~:_ Qty. )'Nla/~ 1. .,"I;_ost.:. '1.''''',:-".;f:~''..Y;;'.'.:'>''''''_ ,-".."r'~ ;I'.';;i; ''-':,;'','. :"~''''. ..,.,.... Residential, per unit, service included: 1,000 sq. ft. or less (4) $134.00 $ Each additional 500 sq. ft, or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 20 I to 400 amps (2) $ 95.00 $ 40 I to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) V $ 63.00 '\11-1, Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 201 to 400 amps (2) $ 87.00 $ 40 I to 600 amps (2) $126.00 $ Qver 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.00 $ b, Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) .". ,,,$ 55.0 $ Each additional branch circuit . 0<' ~~~ $ Miscellaneous fees: service or fle.de~'\h~ I ,\'0 \' ", ~\t\)!;'rI>3';'tio Eac~~P.'\~RI;,t;~~'c'I~~~~lI'l\\S ' $ Eacli..~i~If,9l?o'\,.li ~I.lI\\ X? f>-\)f>-"" D' $ 63.00 $ Signai~c:i.ti\M~d;~~,\~~ ~~el, $ 63.00 $ alterat!<WfR\\~xrenslRio.(~)1' \. Each ad~mO:n~;q\lspection: (I) $58.00 $ ~q~1<':\'1.4!r~{0!;im\t~ifp~2~irARP DiCANt.i~r05E'B~;;;;c;:tt;,~.;.::~':;'.:&l:::;;'~Aj;i'j., ,:~; ,'W;L.<:".!....a.\r2':;'"...:;:0:}{1$,><:'I<~,':,;~,~ _, _ ."'",' _ _'. ,,_ ._,_ -, i~'. __.. 1':;:(&\l..;f,11;~'J;.,r.;,:}~J::,3:~~-'i'b':"~L.'. 1 tA) Enter subtotal of above fees $b3, (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [AD $ 7~g (e) Technology Fee (5% of [AD $ c: f)- TOTAL rees and surcharges (A through C): $ 7'<Z!.:. , CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01655 IVR Number: 811168263153 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/01/2011 ISSUED: APPLIED: 07/01/2011 07/01/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or,us EXPIRES: VALUE: 12/27/2011 $0.00 SITE ADDRESS: 2261 5TH ST, Springfield. OR 97477 ASSESOR'S PARCEL NO: 1703262101900 SCOPE: Electrical Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service reconnect Phone Number: OWNER: ADDRESS: LOCKLEAR JUNEANN K & BARRY E 2261 N 5TH ST SPRINGFIELD OR 97477 Contractor Type Electrical Contractor Contractor Name OWN ER CONTRACTOR INFORMATION ~ Lie Type OWNER BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # of Units: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: lic No 0000000 Lie Exp 08/12/2025 Phone Lot Size: Sq Ft 15t Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: o Site Information ~ Engineere'd Fill: Fill Volume: Flood Hazard Area: Land Hazard Are1iTTENTION: Oregon law requires you to Retaining Wail: foJloliY rules adopted by the Oregon Utility SOIls Report R"1II\W~/tiation Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344), NOTICE:' .".'t" THIS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT' COMMENCED OR IS ABANDONED FOR .;" ANY 180 DAY PERIOD. Springfield Building Permit 7f1/2011 11:52:48AM Page 1 of 3 SPZ~N~ ~~ ~OReGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01655 IVR Number: 811168263153 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@cj,springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/01/2011 ISSUED: APPLIED: 07/01/2011 07/01/2011 EXPIRES: VALUE: 12/27/2011 $0.00 SITE ADDRESS: 2261 5TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703262101900 SCOPE: Electrical Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service reconnect Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMATION I Overlay Oist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: ./ PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes; Sidewalk Type: Downspout/Drains: Valuation Description I Descriotion Tvoe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID ~ Descriotion Service reconnect only State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) Total Amount Paid Amount Paid $63.00 $7.56 $3.15 $73.71 Date Paid 07/01/2011 07/01/2011 07/01/2011 Redot # 2011001855 2011001855 2011001855 Springfield Building Permit 7/112011 11 :52:48AM Page 2 of 3 srA~~;:~ ~; OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01655 IVR Number: 811168263153 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennitce nter@ci.springfield.or,us P~OJECT STATUS: STATUS DATE: ISSUED: APPLIED: 07/01/2011 07/01/2011 Issued 07/01/2011 EXPIRES: VALUE: 12/27/2011 $0.00 SITE ADDRESS: 2261 5TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703262101900 SCOPE: Electrical Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service reconnect Plan Review I Department Application Acceptance Received Due Date ComDleted Result 07/01/2011 07/01/2011 07/01/2011 Over the Counter Reviewer David Bowlsby Electrical Review 07/01/2011 07/01/2011 07101/2011 Comments: Over the counter permit "1Iniii~1 Revl€0~; " _-::7':r:oilo~2R1:D:07/0~/20{l Q7/81/2011 ,'Comments::t:;Over;thecounterpermIL0;c\ ~ - ~""t;t\\, P A..... ,....,.'.;....~,.."..,~ . """:~,:-,' -. ::1<>"" Not Required David Bowlsby .Ove{the'Count~rJ:tt,;;.: 'DavkLBow[bY'~_ \.m["'~ ' f'~:-~--:~l ; ".' f ":~~;:~.~;/ .:-~- :~."'i~__',4',;/": -'";,, ,./ ~<,p~- ~,"-,- ---- ,..--_ .;.' I ~, ~_" ,- ,>ji$7:;d'';'C ~ ~: __ _~ INSPECTIONS REQUIRED I Inspections 4200 Reconnect Service By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. #/JtR_,tjhJ". O~i"'r or Contractor Signature (~&~ - D~eJJ;y ~II Springfield BUilding Permit 7/1/2011 11:52:48AM Page 3 of3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth $t Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01655 2261 5TH ST permitcenter@ci,springfield.or.us RECEIPT NO: 2011001855 RECORD NO: 811-SPR2011-01655 DATE: 07/01/2011 [bESCRIP..TION::;..::':::c..-:;;--':/;;'.;"::'-;".'.:I'''''' ,. 'ACCOUNJi.CQD'E:.. ,,"c, ,. "':AM0UNtOUE ,'-.j Service reconnect only 224-00000-426102 63.00 State of Oregon Surcharge (12% of applicable fees!. 821-00000-215004 7.56 Technology fee (5% of permit total) 100-00000-425605 _ .._,., __,._ 3.15 TOTAL DUE: 73.71 I ~RAYMENT:rYF?E'\' ':PA,(OR',~-;CASH!!fR:ll:l~o"'LSBj/"'-L,JCOMMEN'fS"\",l0.i;.;i#,;Z:_ '- . """fAMQUNT:PAID - -'.;f.-;'. .1 Cash juneann locklear $73.71 TOTAL PAID: $73.71 IJ ,/ Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.055 (4)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: D I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date D I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or l)] I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Ju Y\~.l+v-.r- L6CJde.wV . Print Name of Permit Applicant {/~,y~ .I JJo (tJ I ( Dale : Permit #: S l'tZ.ZO II - D I b S ~ 2--Z6( stl St- c;:f I=-~ t>./L ., 7 C{ 77 Dale: 7;;11 / / Address: Issued by: ~ 1- This Copy for Permit Offices